The review, led by Ingrid Toftaker of the Norwegian University of Life Sciences and Karin Berggren Gustafsson of the Swedish University of Agricultural Sciences, set out to map how digital educational games are actually being used in veterinary medicine. The team searched Web of Science, Medline, and Scopus following the Population/Concept/Context framework and PRISMA-ScR guidelines, ultimately identifying just thirteen veterinary education publications. For comparison, they cataloged 177 articles from human medical education. The contrast is striking: for every published report of a digital educational game in veterinary teaching, there are more than a dozen in human medicine.

The timing of the surge is telling. Ninety percent of the 190 papers included in the review were published after January 2014, reflecting a decade of rapid growth in both fields. The majority of first authors were affiliated with institutions in the United States, and the top five countries represented, all in Europe or North America, accounted for half of the total. In both veterinary and human medical education, most games were implemented in clinical science courses, with veterinary education showing 69.2 percent of games in clinical sciences and human medicine 71.8 percent. Undergraduate teaching dominated in both disciplines, though veterinary education was even more skewed, with 92.3 percent of games used at the undergraduate level compared to 83.6 percent in human medicine.

What counts as a digital educational game? The researchers faced a definitional minefield, since the literature offers no universally accepted term for these activities. They settled on a simplified version of Salen and Zimmerman’s classic definition: an activity with some rules engaged in for an outcome. To be classified as a game, an activity had to contain at least two of five predefined game elements: rules, goals, interaction with others, challenge, and feedback or outcome. The games that met this bar varied enormously in design and purpose, from a neuropathology iBook where students reach diagnoses by answering case-based questions, to a digital scavenger hunt app called Actionbound that sends veterinary neurology students into the forest with GPS assistance, to a handwashing simulator called SureWash that uses camera recognition to assess hygiene technique.

Several games stand out for their technical sophistication. The LamenessTrainer, developed in the United Kingdom, shows students videos of horses in motion and asks them to identify whether and on which limb the animal is lame, awarding points for correct answers while incorrect responses cost virtual lives. The Veterinary DialogueTrainer, used in Finland and Sweden, places practicing bovine veterinarians in digital role-play scenarios with a virtual dairy farmer, where selecting predefined interaction options generates scores based on conversational outcomes. In the United States, the Virtual Oncology Clinic lets third-year students work through medical scenarios from anamnesis uptake to diagnosis and treatment within a virtual animal hospital. These simulations aim to replicate real-world clinical decision-making without requiring live animals, a benefit that is becoming more valuable as stricter policies on animal use in teaching push educators toward alternatives.

The evaluation evidence, however, is where the review exposes real weaknesses. Ten of the thirteen veterinary articles included some form of evaluation, with six assessing cognitive learning outcomes and eight examining affective outcomes such as motivation, confidence, and perceived competency. The cognitive findings were mixed: some studies reported positive effects on learning, others found no significant differences, and one study, evaluating the Interactive Neuropathology iBook with a post-test-only control group design, found lower scores on some questions for the intervention group. Only two veterinary studies included control groups that did not interact with the game, and only one used a systematic allocation procedure, a matched block design based on pre-test performance. Most evaluations relied on repeated scoring within the game itself or pre- and post-course assessments, which cannot isolate the effect of the game from other educational conditions.

The affective results were more consistent. Students generally perceived games positively, reporting increased autonomy, better understanding of decision-making complexities, and greater confidence in specific clinical scenarios. In the Territory Game, where students collaborate to create a business plan for a veterinary practice using digital informational cards, participants reported enhanced understanding of the complexities of decision-making. In the Actionbound study, students found the game enjoyable and engaging, with outdoor play potentially further boosting motivation. But enthusiasm does not always translate into engagement: in the SureWash hand hygiene study, only 13 percent of students chose to interact with the system, a sobering reminder that game elements do not inherently guarantee motivation for all learners.

Perhaps the most practical problem the review uncovered is accessibility. Information on how to access the games was often incomplete, restricted, or entirely absent. While some games offered partial access through demo versions or test cases, only one, the LamenessTrainer, was fully accessible to the reviewers. This limited availability hinders the sharing of learning resources across institutions, makes it difficult for educators to evaluate or adopt these tools in their own teaching, and reduces the potential for replication and evidence building. The researchers also note that many educational games likely never appear in the scientific literature at all, and no comprehensive repository of digital games for veterinary learning currently exists.

The broader literature on gamification in education offers cautious optimism. Meta-analyses by Huang and colleagues and by Sailer and Homner found small to medium-sized positive effects on cognitive learning outcomes, though effects on motivational and behavioral outcomes were less stable. Both meta-analyses emphasized significant heterogeneity among studies, and both investigated moderators of effect, finding that contextual factors like subject area and educational level, as well as specific game elements like quests, leaderboards, and collaboration, influence effectiveness. Gentry and colleagues concluded that serious games appear to be at least as effective as traditional methods, and often more effective for improving knowledge, skills, and satisfaction.

For veterinary education specifically, the stakes are high. Veterinary graduates are licensed for practice across all animal species immediately after graduation, without the mandatory supervised internships that medical doctors complete. The need for effective training on realistic scenarios is therefore even more critical for veterinary students than for medical students. The review’s authors call for more veterinary educators to publish detailed accounts of their game-based approaches, clearly describing contextual factors, game elements, and associated outcomes. They also emphasize that future research should move beyond simply asking whether games improve learning, and instead investigate how and under what conditions game-based learning is most effective. Until then, the promise of digital games in veterinary education remains just that: promising, but unproven.

Subject of Research: Digital educational games in veterinary education: a scoping review with comparison to human medical education

Article Title: Digital educational games in veterinary education: a scoping review with comparison to human medical education

Article References: Toftaker, I., Berggren Gustafsson, K., & Tamminen, L.-M. (2026). Digital educational games in veterinary education: a scoping review with comparison to human medical education. Frontiers in Veterinary Science, 13, Article 1929108. https://doi.org/10.3389/fvets.2026.1929108

Image Credits: AI Generated

DOI: 10.3389/fvets.2026.1929108

Keywords: Digital, educational, games, veterinary, education, scoping, review, comparison, human, medical, scientific research